Insomnia and sleep disorders: Understanding and managing these as we age

The Bottom Line

  • Insomnia disorder is a dissatisfaction with the quality or the quantity of sleep that we experience. This includes difficulty falling asleep, difficulty going back to sleep after waking up at night, or waking up very early in the morning and not being able to go back to sleep.
  • The symptoms occur at least three nights a week for three months or more, though many individuals can experience it for years; and the sleep disturbance causes significant distress or impairment in functioning.
  • The first-line treatment for insomnia disorder is cognitive behavioural therapy for insomnia (CBT-I).
  • Medication treatments for insomnia, while common, show little benefit and can pose significant risk of harm, particularly for older adults.

Sleep problems are common in older adults and can include difficulty falling or staying asleep (insomnia), breathing problems, or abnormal behaviours during sleep. In this webinar recording, geriatric psychiatrist Dr. Sophiya Benjamin provides an overview of both the causes and effects of poor sleep, exploring disorders and medications associated with sleep disturbances. You’ll learn about how sleep problems are assessed and diagnosed, as well as treatment and management strategies, including measures to promote good ‘sleep hygiene’, cognitive behavioural therapy for insomnia, and helpful resources.

 

 

Learn the answers to the following questions:

  • 1:27 What is a normal circadian rhythm?
  • 2:53 What are the different stages of sleep?
  • 4:06 What are some age-related changes to sleep?
  • 5:25 What are the various sleep disorders?
  • 6:30 What are restless leg syndrome, REM sleep behaviour disorder, and substance or medication-induced sleep disorders?
  • 8:40 What is sleep apnea?
  • 9:56 What is insomnia disorder?
  • 17:23 How is insomnia disorder treated and assessed?
  • 20:12 What is cognitive behavioural therapy for insomnia (CBT-I)?
  • 31:21 What medication treatments are there for insomnia?
  • 36:55 How do alcohol and cannabis affect sleep?
  • 39:30 What resources are available to help with insomnia disorder?
  • 42:00 Are there medications that are known to worsen insomnia?
  • 43:44 Are melatonin and magnesium effective for insomnia?
  • 47:10 Are over-the-counter sleep medications bad for you?
  • ​​48:54 Can meditation help with falling asleep?
  • 51:21 What are the effects of screen time, reading, or using audiobooks before falling asleep?
  • 52:18 What should I do if I have to wake up in the night to urinate?
  • 53:53 Should I be napping?
  • 55:02 Is there an association between sleep disorders and dementia?
  • 56:04 How is a sleep assessment done by a health care professional?
  • 58:18 Are wearable devices accurate in tracking sleep metrics?
  • 59:38 What is the role of hormones in insomnia during menopause?
  • 1:01:18 Are there medical conditions that can cause insomnia?

Download a handout with helpful resources related to sleep disorders and insomnia.

Download a transcript of this webinar presentation.

Want to test your knowledge about insomnia? Take this 6-question quiz.

Give us your feedback with this 2-question survey.

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References

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  2. American Academy of Sleep Medicine: A Patient’s Guide to Understanding Behavioral and Psychological Treatments for Chronic Insomnia Disorder in Adults. https://aasm.org/wp-content/uploads/2021/08/Behavioral-and-Psychological-Treatments-for-Insomnia-Patient-Guide.pdf
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  30. Woo T, Levinson AJ. Insomnia: Are Sleeping Pills the Answer? (video post), McMaster Optimal Aging Portal. January 29, 2024. Accessed January 19, 2024. https://www.mcmasteroptimalaging.org/blog/detail/videos/2022/01/19/insomnia-are-sleeping-pills-the-answer?sid=f2348846-7fb2-4eaa-b8bd-9ed18c3b4841&hl=insomnia

DISCLAIMER: These summaries are provided for informational purposes only. They are not a substitute for advice from your own health care professional. The summaries may be reproduced for not-for-profit educational purposes only. Any other uses must be approved by the McMaster Optimal Aging Portal (info@mcmasteroptimalaging.org).

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